Surprise! Cities are safer than rural areas!

For years, people have moved to the country to escape the dangers of big city life. But new research suggests that they may be better off staying put.

A study called “Safety in Numbers: Are Major Cities the Safest Places in the United States?” was published this week by the American College of Emergency Physicians. The researchers, led by Sage R. Myers of the Children’s Hospital of Philadelphia, noted that until their work, the overall injury risk in urban areas versus suburban and rural areas had not been fully described.

So Myers’s team attempted to classify deaths from injuries “across the rural-urban continuum.” They looked at data on 1,295,919 deaths from injuries in 3,141 U.S. counties from 1999 to 2006. These deaths were caused by car accidents, shootings, falls, drowning, suffocation, and more.

The researchers found that the risk of death from injury was 1.22 times higher in the most rural counties, compared with the most urban ones…

In the paper’s introduction, the authors note that overall deaths from injury have historically been higher in cities. But they noted that since 2008, more than half of the world’s people have lived in urban areas. In the U.S., as in many other countries, urban counties have more people than rural ones. And when the number of deaths from injuries are averaged out across that higher population, it turns out that the risk to any given individual looks lower for urban dwellers.

In addition to that statistical effect, the researchers noted, “Paradoxically, research also exists suggesting that rural areas bear a disproportionately high level of risk for certain serious injuries such as suicide and motor vehicle injuries, raising the possibility of increased safety threats to rural inhabitants.”

The paper also noted that trauma physicians tend to be more accessible and better trained and equipped in urban areas, which may contribute to lower death rates from all kinds of injuries.

People in rural areas also tend to spend more time doing what the researchers deemed the most dangerous activity: riding in cars. In the time period of the study, death from motor vehicle accidents occurred at a rate of 14.9 people per 100,000.

The next most common cause of death by injury, guns, occurred at a rate of 10.4 people per 100,000. Further down the list were poisoning, drowning, suffocation, and falls.

Overall, the injury death rate was 56.2 people per 100,000. The rate for unintentional injury was 37.5 per 100,000, while the rate for intentional injury (homicide and suicide) was 17 per 100,000.